Deutsche medizinische Wochenschrift
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Autoimmune gastritis (AIG) is a chronic immune-mediated inflammation of the gastric corpus/fundus mucosa leading to progressive atrophy of the oxyntic gastric glands (AOM) and their consecutive loss of function. Possible clinical consequences of AIG include iron deficiency anemia, pernicious anemia, gastric neuroendocrine tumors (gNET), and gastric adenocarcinoma. This article provides a review of interdisciplinary aspects of the diagnosis and treatment of AIG.
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The measurement quality of systems used for determination of glucose concentrations has to be sufficiently high to obtain measurement results that are reliable in a clinical context regarding the intended use (e. g., diabetes diagnosis and monitoring). The "Richtlinie der Bundesärztekammer zur Qualitätssicherung laboratoriumsmedizinischer Untersuchungen" (guideline of the German Medical Association on quality assurance in medical laboratory examinations) includes specifications on the internal and external quality assurance that are legally binding for glucose measurements in healthcare. ⋯ With systems for continuous glucose monitoring, there are currently no technological means to regularly check measurement quality. Additionally, repeated manufacturer-independent evaluations, which could lead to improved measurement quality, are not available.
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Dtsch. Med. Wochenschr. · Apr 2022
Letter[Considerations on Excess Mortality in Germany in the year 2020 and 2021].
At the end of 2020, in Germany a discussion broke out whether the past year was characterized by excess mortality. The opposite positions arose primarily from the way data was processed. In order to correct systematic trends of the last two decades, in the present study the annual death rates for Germany were calculated as the difference to those of the year 2000 and a polynomial fit of 2nd order was carried out for the total population and for the groups of people below and from 80 years of age. ⋯ For the total population there were excess mortality rates for 2020 and 2021 with 11 500 and 10 468 deaths respectively, which in which in total is completely covered by the excess mortality of those aged 80 and over. In the age group below 80 years there was no excess mortality in the two years. For all age groups, excess mortality was most prominent in the year 2003.
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Dtsch. Med. Wochenschr. · Apr 2022
Case Reports[BCG-therapy as a rare reason for postrenal failure].
In the following case report, we describe a patient with acute renal failure due to an urinary congestion level II-III under BCG-(Bacillus Calmette-Guérin)-therapy because of bladder cancer. Cystoscopy revealed the diagnosis of BCG-induced intramural narrowing of distal ureters bilaterally. ⋯ Although postrenal failure is relatively rare (5 %), also seldom causes such as medication-induced (e. g. BCG) ureter stenosis has to be included into the differential diagnosis.
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Dtsch. Med. Wochenschr. · Apr 2022
[Lower back pain in the primary care setting - Non-specific and specific pain].
A systematic survey of the symptoms of back pain in terms of triggering event and onset, nature and the extent of influenceability of the pain (lying or standing, under stress, nocturnal pain, localized percussion tenderness, B- symptoms, etc.), as well as structured clinical examination (segment height, radiance, projection, reflex status, sensitivity and motor function) allows an initial and therefore orienting classification of back pain as non-specific or specific. In the primary care setting many patients can be treated extremely effectively and economically from a cost perspective. In addition to the fastest possible pain relief, it is important to prevent the disease becoming chronic. ⋯ Causes of specific back pain include: fractures, infections, radiculopathy, tumors, axial spondylarthritis as well as extravertebral causes. In the further cause of treatment, it may be necessary to consult medical specialists in the fields of radiology, orthopedics, neurology, neurosurgery, rheumatology, psychotherapy, psychiatry, among others. Treatment is managed by the primary care provider, who should also receive and re-evaluate all findings during the course of the disease.